title: Ipsilateral circumferential radiofrequency ablation of atrial fibrillation with irrigated tip catheter: long-term outcome and pre-procedural predictors.
abstract: BACKGROUND
  Predictors of long-term outcome of atrial fibrillation (AF) ablation are unknown. The predictors of 5-year follow-up (FU) after single ipsilateral circumferential antrum pulmonary vein isolation (PVI) with irrigated tip catheter were investigated.
  
  
  RESULTS
  In 356 patients (74% male) with AF (44% paroxysmal AF [PAF]) PVI was performed. Success was defined as absence of AF, atrial flutter or tachycardia (AFLAT) recurrence. A total of 161 patients (45%) were free of AFLAT. The univariate predictors of AFLAT recurrence were: type of AF (non-PAF vs. PAF, P=0.0001), size of LA (normalized left atrium area [NLA] ≥11.5 vs. NLA <11.5, P=0.0001), renal function (glomerular filtration rate [GFR] <68ml/min vs. GFR ≥68ml/min, P=0.001) and hypertension (HT vs. no HT, P=0.025). The independent predictors of AFLAT-free survival were non-PAF (hazard ratio [HR], 1.67; 95% confidence interval [CI]: 1.23-2.26, P=0.0005), NLA ≥11.5 (HR, 1.40; 95% CI: 1.03-1.90, P=0.007) and GFR <68ml/min (HR, 1.70; 95% CI: 1.21-2.37, P=0.008).
  
  
  CONCLUSIONS
  Single PVI results in a moderate success rate in patients with AF during 5-year FU without the use of a 3-D mapping system. Higher success was observed in patients with PAF, non-enlarged LA and good renal function.
authors.affiliation: Department of Cardiology, Kerckhoff Heart and Thorax Center.
authors.forename: Maciej
authors.initials: M
authors.lastname: Wójcik
authors.forename: Damir
authors.initials: D
authors.lastname: Erkapic
authors.forename: Alexander
authors.initials: A
authors.lastname: Berkowitsch
authors.forename: Sergey
authors.initials: S
authors.lastname: Zaltsberg
authors.forename: Harald
authors.initials: H
authors.lastname: Greiss
authors.forename: Jörn
authors.initials: J
authors.lastname: Schmitt
authors.forename: Dimitri
authors.initials: D
authors.lastname: Pajitnev
authors.forename: Stefan
authors.initials: S
authors.lastname: Lehinant
authors.forename: Johannes
authors.initials: J
authors.lastname: Rixe
authors.forename: Christian W
authors.initials: CW
authors.lastname: Hamm
authors.forename: Heinz F
authors.initials: HF
authors.lastname: Pitschner
authors.forename: Malte
authors.initials: M
authors.lastname: Kuniss
authors.forename: Thomas
authors.initials: T
authors.lastname: Neumann
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000401:mortality* / Q000601:surgery*; D062906:Cardiac Catheters; D017115:Catheter Ablation; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate